Internal Form
Bug Busters — internal use only
Clear
Generate Internal Form PDF
SERVICE INFO
Customer Name
Account Number
Initial Service (date)
Follow-ups
Routine Service
Tip: link in with
?name=…&account=…
to auto-fill from the agreement.
EQUIPMENT LIST
Exterior Rodent Stations
$30 each
Qty
Total $
Interior Rodent Bait Stations
$ ea
Qty
Total $
Rodent Tin-cds (Commercial)
$15 ea
Qty
Total $
Rodent Snap Traps
$7 / $1 ea
Qty
Total $
Ant Stations
$ ea
Qty
Total $
Mosquito Traps
$8 / month
Qty
Total $
Weighted
Un-weighted
Decor (Rock)
Utility Box
INTERNAL NOTES
AGREEMENT CHECKLIST
Customer Name and Address
(2) Names & Phone Numbers
Email Address
Billing Address
Service Frequency Checked
Documented Access
Call, Text, Email Checked
Auto Pay Initiated & Auto Draft Date
Customer Signature
Rep Signature & Date
Correct Prep Sheets Attached
Roach Corrective, Flea, Bed Bug Prep
Correct Agreement Pricing
Frequency of Payment (Monthly/Quarterly)
Correct Payment Information (Card/Check/Cash)
Picture of Cash/Check Uploaded in FR
SERVICE EQUIPMENT
Hepa Vac
Actisol machine
Ozone Machine
Micro Jet Fogger
Auger (Trelona)
Extension Applicator
Bee Suit
EXCLUSION
Wire Mesh
Spray Foam
Gable Vent Screen
Backer Rod
Putty
Vent Cover
Vent Replacement
LADDERS / LIFTS
8 Ft Ladder (1 Man)
12 Ft Ladder (1 Man)
24 Ft Ladder (2 Man)
40 Ft Ladder (2 Man)
Boom Lift (days)
BED BUG / PROPERTY DETAILS
Stick Built
Double-wide
Single-wide
Slab
Crawl Space
Basement
Adequate Electrical
Clear
Generate Internal Form PDF